- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $324.41 / $1,208.90 / $9,062.00
| Facility | | $324.41 | $1,208.90 | $9,062.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $520.00 / $1,368.41 / $3,447.14
| Facility | | $520.00 | $1,368.41 | $3,447.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $360.00 / $425.00 / $1,139.16
| Facility | | $360.00 | $425.00 | $1,139.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $138.40 / $206.77 / $1,592.50
| Facility | | $138.40 | $206.77 | $1,592.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $586.00 / $6,172.00 / $8,667.00
| Facility | | $586.00 | $6,172.00 | $8,667.00 |